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Everything You Need to Know About Workers’ Compensation Appeals

Insurance companies will scrutinize workers' compensation claims to deny benefits to deserving injured workers. While some simple errors can be avoided, other errors could be due to not fully understanding workers' compensation laws. Not having experience with insurance companies and knowing the tactics they use can also be the reason for a denied claim. In short, the workers' compensation process is complicated. If you've been denied workers' compensation benefits, here's what you need to know before getting started with the appeals process.

Top Reasons for Denied Workers' Comp Claims

Understanding the reasons why workers' compensation claims get denied can help you avoid losing your case.. Here are the top reasons for workers' compensation claim denials:

Lack of Information on the Work Accident Report

Your work accident report is a critical piece of evidence in your workers' compensation claim. Be sure to give as much detail as possible. When filling out your work accident report, be sure to include all required information including:

  • Date, time, and location of the work accident

  • Names of all witnesses to your injury

  • Parts of the body that were injured

  • Supporting medical records and other related medical documentation

  • Additional personal information (i.e., date of birth and social security number)

Missed Deadlines

Workers' Compensation claims have strict deadlines that must be abided by. Failing to submit documents and medical information can cause you to miss out on the benefits that you deserve. Be sure to provide the following timely:

  • Work injury report

  • Workers' compensation claim application

  • Appeals: if your workers' compensation claim has been denied, you have the right to appeal. Your denial letter will provide you with a deadline date to file an appeal. Submitting all documentation and medical evidence to support your appeal by the deadline date is critical to receiving a favorable outcome.

Paperwork Errors

Workers' compensation claims can involve a lot of paperwork. When filling out forms and submitting documents, it can be easy to overlook seemingly minor details. Missing information on workers' compensation paperwork can only give the insurance company an easy and good reason to deny your claim. It's crucial to read all forms thoroughly when filling them out as well as follow directions on what documentation needs to be attached.

Lack of Medical Evidence

In addition to your work accident report, medical evidence is another critical component to having a valid claim. Without medical documentation and other medical evidence, there is no case. It's also vital to ensure you are receiving proper treatment for your injury. Follow all medical recommendations from your doctor related to your work injury.

Failing to Enlist the Help of a Workers' Compensation Lawyer

Many injured workers attempt to file a workers' compensation claim on their own — and many claims get denied as a result. Not understanding workers' compensation laws, how the insurance companies deny claims, and lack of experience can make filing a workers' compensation claim both frustrating and challenging. Having an experienced workers' compensation attorney on your side can make all the difference in the outcome of your claim. For the best chance of getting a favorable decision, contact a skilled workers' compensation lawyer as soon as possible after you've been injured on the job.

How Long Does a Workers' Compensation Appeal Take?

The answer is, it depends. There is no set time frame for a workers' compensation appeal decision to be finalized. However, here are some ways you can ensure you get your case reviewed by the workers' compensation board sooner than later so you can begin receiving workers’ compensation benefits as soon as possible:

  • Speak to an attorney immediately after receiving your denial letter

  • Keep all medical documentation in a convenient place for easy access

  • Review all paperwork for any errors and correct promptly

  • File your appeal paperwork within 30 days of your denial letter

If you've been injured at work and need assistance with a workers' compensation claim, contact Spellen Law, LLC today at

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